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  • 1.
    Expert Consensus on the Management of COVID-19 in Solid Organ Transplant Recipients (2023 edition)
    National Center for Infectious Diseases, Chinese Medical Association Organ Transplantation Branch, Organ Transplantation Rehabilitation Committee of the China Society of Rehabilitation Medicine, Special Fund for Health Management of Organ Transplant Recipients of the China Organ Transplantation Development Foundation
    Chinese Journal of Transplantation(Electronic Edition) 2023, 17 (02): 65-81. DOI: 10.3877/cma.j.issn.1674-3903.2023.02.001
    Abstract (305) HTML (88) PDF (2894 KB) (145)

    Since the end of 2019, the novel coronavirus infection pandemic has swept the world. Although the current novel coronavirus mutants have decreased in pathogenicity and virulence compared with the original strains, and most patients have a good prognosis, the solid organ transplant (SOT) recipients are vulnerable to novel coronavirus. And even with vaccination, the risk of hospitalization or death is still high in SOT recipients infected with novel coronavirus. What′s more, the clinical manifestations, diagnosis and treatment strategy of SOT recipients infected with novel coronavirus has its unique features, which need high attention. At present, there is a lack of guidelines or consensus in the diagnosis and treatment field of novel coronavirus for such a large number of SOT recipients. Therefore, referring to the "Diagnosis and treatment plan of coronavirus (Trial Version 10)" and global published literature, the writing team wrote the "Expert consensus on diagnosis and treatment of novel coronavirus infection in solid organ transplant recipients (2023 edition)" . This consensus was evidence-based written and reached by experts after multiple rounds of discussions, forming 21 recommendations, providing reference for the diagnosis and treatment of SOT recipients infected with novel coronavirus.

  • 2.
    Expert guidance on prophylaxis strategies and health management of organ transplant recipients infected with COVID-19 in China (first edition)
    Committee of Health Management for Organ Transplant Recipient, China Organ Transplantation Development Foundation
    Chinese Journal of Transplantation(Electronic Edition) 2023, 17 (01): 1-12. DOI: 10.3877/cma.j.issn.1674-3903.2023.01.001
    Abstract (184) HTML (31) PDF (2261 KB) (100)

    自2019年新型冠状病毒感染(COVID-19)首次发现以来,截至2022年12月21日,全球确诊病例已超过6.49亿例,且死亡病例达660多万例[1]。目前我国境外输入和本土疫情的新型冠状病毒(以下简称"新冠病毒")主要流行株是奥密克戎变异株[2]。该病毒变异株传染性更强、传播速度更快、再感染率更高,在已接种新型冠状病毒疫苗(以下简称"新冠疫苗")的人群中易发生免疫逃避及突破感染[3]。实体器官移植受者(solid organ transplant recipient,SOTR)因长期使用免疫抑制剂,且可能伴有高血压、糖尿病等慢性基础性疾病,感染新冠病毒后重症率和病死率均高于普通人群[4]。按照中华人民共和国国家卫生健康委员会印发的《新型冠状病毒感染诊疗方案(试行第十版)》[5]中将"免疫功能缺陷(如长期使用皮质类固醇或其他免疫抑制药物导致免疫功能减退状态)"人群列为重型/危重型高危人群之一。因此,应高度重视SOTR感染新冠病毒的健康管理,优化其预防、早期诊断和治疗策略。

  • 3.
    Consensus on quantify monitoring and assessment of immune cell function status and clinical application
    China International Exchange and Promotive Association for Medical and Health Care (CPAM), Society of Liver Transplantation,, China International Exchange and Promotive Association for Medical and Health Care (CPAM), Society of Kidney Transplantation;, China Medicinal Biotech Association (CMBA), Society of Biological Diagnostics
    Chinese Journal of Transplantation(Electronic Edition) 2024, 18 (02): 65-73. DOI: 10.3877/cma.j.issn.1674-3903.2024.02.001
    Abstract (294) HTML (28) PDF (2524 KB) (100)

    The immune system is the important guarantee for maintaining the health of organ function and preventing diseases. The goal of immune health management and immune treatment is to restore the normal function of the immune system. The technical problems of how to inhibit or enhance the immune status has been solved in the field of immunology, but how to comprehensively detect and quantitatively evaluate the immune status is still a challenge. There is no mature solution at present. The quantification detection and visualization evaluation of immune status are of great significance for disease prevention and control, sub-health status management, and immune treatment. This expert consensus has carried out preliminary discussions on the definition of normal immune status and the comprehensive quantitative evaluation and visual scoring techniques of immune cell function status (immune function), put forward the basic concepts and thinking related to normal immune status, discussed the direction and principles of quantitative detection and evaluation of immune cell function status, and taken this as an opportunity to promote the decoding of immunity and the study of basic and clinical trials in the field of immune health.

  • 4.
    Current status and progress on antibody-mediated rejection in heart transplantation
    Shouguo Yang
    Chinese Journal of Transplantation(Electronic Edition) 2022, 16 (05): 266-276. DOI: 10.3877/cma.j.issn.1674-3903.2022.05.002
    Abstract (154) HTML (16) PDF (2287 KB) (73)

    Antibody-mediated rejection (AMR) is proved to be a crucial complication in heart transplantation, which has not been well evaluated and studied in China. Nowadays, it is considered that AMR contains a series of evolution process from pathological changes to clinic manifestation, which starts with the accumulation of immune factors (such as antibody, complement), the activation of complement and ends with graft tissues injury. Clinically, AMR was classified as circulating antibody silent stage, sub-clinical stage and symptomatic AMR stage. The mechanism of AMR involved in an inflammatory reaction induced by deposition of immunoglobulins and complements within the microvessels of the grafts, in which the activation of complements played a core role. Therefore, immunological assay of C4d and C3d in endomyocardial biopsy specimens combined with evidence of histopathology capillaries injury were necessary for the diagnosis of AMR. While noninvasive gene detection with Allomap and donor-derived cell-free DNA were effective method serving as screening and monitoring AMR. Recommendations on management of AMR consisted a combination of corticosteroid, intravenous immune globulin, plasmapheresis or rituximab by scale of AMR, which were proven to be effective against immune injury. However, the efficacy of anti-CD52 monoclonal antibody, eculizumab and photochemotherapy remains to be further evaluated.

  • 5.
    Chinese expert consensus on clinical application of inhibitors of mammalian target of rapamycin in liver transplant recipients (2023 edition)
    Committee of Health Management for Organ Transplant Recipient, China Organ Transplantation Development Foundation, Branch of Organ Transplant Physicians of Chinese Medical Doctor Association, Branch of Organ Transplant of Chinese Medical Association, National Center for Healthcare Quality Management in Liver Transplant
    Chinese Journal of Transplantation(Electronic Edition) 2023, 17 (04): 193-204. DOI: 10.3877/cma.j.issn.1674-3903.2023.04.001
    Abstract (100) HTML (11) PDF (1541 KB) (68)

    肝移植是治疗终末期肝病最有效的方法。随着外科技术和免疫抑制药物的发展,肝移植受者和移植物生存率已显著提高。根据中国肝移植注册中心(China Liver Transplant Registry,CLTR)数据,2015至2021年我国共实施肝移植35 566例,公民逝世后器官捐献肝移植和活体肝移植受者术后1、3、5年生存率分别为83.7%、74.5%、68.9%和92.4%、89.3%、88.2%[1]。肝移植受者的长期存活和生存质量很大程度上取决于术后中长期健康管理和免疫抑制方案。长期服用免疫抑制剂可导致受者出现肾损伤、代谢性疾病和新发恶性肿瘤等严重并发症,甚至增加肝癌肝移植术后肿瘤复发风险[2]。目前肝移植受者常用的免疫抑制方案以钙调磷酸酶抑制剂(calcineurin inhibition,CNI)为基础,其中以他克莫司+吗替麦考酚酯(mycophenolate mofetil,MMF)+泼尼松方案最为普遍。但是CNI引起的肾脏毒性、神经毒性和促进肿瘤复发等问题极大地影响了受者预后,近年来临床逐渐减少其用量并寻求替代药物。

  • 6.
    Research progress on the role of kupfer cell in liver transplantation
    Changjiang Yu, Minjie Zhao, Jianping Gong
    Chinese Journal of Transplantation(Electronic Edition) 2022, 16 (05): 314-318. DOI: 10.3877/cma.j.issn.1674-3903.2022.05.010
    Abstract (50) HTML (0) PDF (739 KB) (63)

    Liver transplantation is recognized as the most effective treatment for end-stage liver diseases. In addition to excellent surgical skills, postoperative ischemia reperfusion injury (IRI) and rejection are important factors affecting the prognosis, long-term survival and life quality of patients. Kupfer cell (KC) is resident macrophages in the liver, which plays a crucial role in the process of IRI, rejection and immune tolerance after liver transplantation. This review summarizes the current status and progress of the research on the effects of KC on IRI, rejection and induction of immune tolerance after liver transplantation.

  • 7.
    A single-center experience of 50 cases of adult lung transplantation
    Wenhui Chen, Lijuan Guo, Li Zhao, Chaoyang Liang, Qingyuan Zhan, Min Li, Run Tong, Qianli Ma, Huaping Dai, Jingyu Chen, Chen Wang
    Chinese Journal of Transplantation(Electronic Edition) 2020, 14 (06): 349-354. DOI: 10.3877/cma.j.issn.1674-3903.2020.06.003
    Abstract (111) HTML (1) PDF (622 KB) (62)
    Objective

    To analyze the perioperative characteristics of lung transplantation (LT) recipients, and to enhance the experience of LT.

    Methods

    The clinical data on 50 consecutive brain-dead donor at Lung Transplantation Center of China-Japan Friendship Hospital from March 1 to December 31, 2017 were retrospectively collected. The median age of recipients was 63 years (27-71 years), including 43 males and 7 females. Thirty-one single LT (SLT) recipients and 19 bilateral LT (BLT) recipients were enrolled. Thirty-eight donors′ age was between 16 to 55 years (median age 37 years). Median PaO2/FiO2 was 444 mmHg (313-600 mmHg, 1 mmHg=0.133 kPa) before donation with ABO compatibility between all donors and recipients. We used Chi-square test or Fisher exact test to compare the perioperative death rate between different groups of age, sex, procedure type, body mass index, primary diseases, blood loss and extracorporeal membrane oxygenation (ECMO) support. Bonferroni method was used to adjust α level in pairwise comparison. Overall survivals of different groups at one year were described by using Kaplan-Meier curves, and Breslow test was used to compare the survival curve between the two groups. A P<0.05 was considered statistically significant.

    Results

    Median perioperative ECMO support time was 2.0 d (0.3 d-13.0 d) in 40 recipients. Median ICU stay time was 4 d (1-60 d). Perioperative survival rate was 84%(42/50), with survival time being 1-49 d in 8 recipients. Perioperative survival rates in BLT and SLT were 31.6% (6/19) and 6.5% (2/31), respectively (P=0.041). One year survival rate in all recipients was 78% (39/50), while it was 87.1% in SLT and 63.2% in BLT, respectively (P<0.05). There were different Kaplan-Meier curves in subgroup of age, primary diseases and ECMO support (P all <0.05). Ten recipients (20%) had donor derived infection. Nine patients (18%) developed airway complications with bronchial stenosis following LT, which 2 patients complicated with anastomotic fistula.

    Conclusion

    Patients with end-stage lung disease can benefit from LT at appropriate time point and comprehensive appreciation and management.

  • 8.
    Application of nanotechnology in tracheal grafts
    Yiqi Sun, Hongcan Shi
    Chinese Journal of Transplantation(Electronic Edition) 2022, 16 (05): 309-313. DOI: 10.3877/cma.j.issn.1674-3903.2022.05.009
    Abstract (72) HTML (0) PDF (741 KB) (62)

    Nanotechnology is a new research direction in tissue engineering of tracheal grafts. Nanotechnology involves not only the nano biomaterials, but also the generation technology of nanofiber structure. Nano biomaterials are mainly divided into inorganic and organic, but in the specific operation, organic nano biomaterials have a broader prospect. There are three main types of nanofiber structure generation technologies: electrospinning, self-assembly and phase separation. Compared with the latter two technologies, electrospinning technology is more convenient and cost-effective. The purpose of this article is to review some important nano biomaterials, the application of nanofiber structure generation technology in tracheal grafts and the prospect of nanotechnology in tracheal grafts.

  • 9.
    Expert consensus on diabetes mellitus after solid organ transplantation in adults
    Organ Transplantation and Rehabilitation Committee of Chinese Medical Association of Rehabilitation
    Chinese Journal of Transplantation(Electronic Edition) 2023, 17 (04): 205-220. DOI: 10.3877/cma.j.issn.1674-3903.2023.04.002
    Abstract (60) HTML (5) PDF (1781 KB) (60)

    Post-transplant diabetes mellitus (PTDM) is a common endocrine and metabolic disorder after adult solid organ transplant (SOT), affecting 10% to 40% of recipients. PTDM has been associated with increased mortality, heightened risk of infections, graft-related complications and cardiovascular diseases, all of which seriously threaten the quality of life and long-term survival of recipients. According to recent studies and the domestic healthcare system, this consensus provides a comprehensive overview of the epidemiology, risk factors, pathogenesis, screening and diagnosis, treatments, prevention strategies, cardiovascular risk factor management and microvascular complications associated with PTDM, in order to further standardize the diagnosis and treatment of PTDM. The objective is to standardize the comprehensive management of PTDM with the aim of enhancing the long-term quality of life and clinical outcomes for SOT recipients.

  • 10.
    Liver transplantation for a pediatric patient with severe hepatopulmonary syndrome
    Conghuan Shen, Ruidong Li, Yifeng Tao, Quanbao Zhang, Xiaofei Zhang, Zhengxin Wang
    Chinese Journal of Transplantation(Electronic Edition) 2018, 12 (04): 180-182. DOI: 10.3877/cma.j.issn.1674-3903.2018.04.009
    Abstract (47) HTML (0) PDF (433 KB) (54)
  • 11.
    Pure red cell aplastia caused by human parvovirus B19 infection after kidney transplantation: 4 cases report
    Rui Xiong, Hua Yang, Xinchang Li
    Chinese Journal of Transplantation(Electronic Edition) 2020, 14 (04): 237-240. DOI: 10.3877/cma.j.issn.1674-3903.2020.04.009
    Abstract (82) HTML (1) PDF (713 KB) (49)
  • 12.
    Expert consensus on the clinical application of monitoring donor derived cell-free DNA in kidney transplantation (2022 edition)
    China Kidney Transplantation-application and research of donor derived cell-free DNA study group, Society of Transplant Technology, China Medicinal Biotechnology Association
    Chinese Journal of Transplantation(Electronic Edition) 2022, 16 (05): 257-265. DOI: 10.3877/cma.j.issn.1674-3903.2022.05.001
    Abstract (1456) HTML (10) PDF (1319 KB) (40)

    游离DNA(cfDNA)反映其来源细胞的病理生理状态,已经广泛应用于肿瘤和产前基因检测。在器官移植领域,供体来源游离DNA(ddcfDNA)作为一种无创"液体活检"标志物在肾移植中越来越被重视,其在各种疾病状态中的价值和意义逐渐被阐释。中国肾移植供体来源游离DNA应用与研究专家组和中国医药生物技术协会移植技术分会组织相关专家参考国内外最新进展,结合我国肾移植临床实际撰写了初稿,广泛征求国内本领域临床一线专家修改意见后统稿完成本共识。共识围绕cfDNA检测与ddcfDNA计算、标本留取规范、ddcfDNA绝对值和相对值的意义、ddcfDNA与移植肾排斥反应(包括与移植肾损伤/排斥反应、供体特异性抗体、亚临床排斥反应、移植肾活检病理的关系、在诊断小管间质性TCMR的作用)、动态ddcfDNA的监测意义、ddcfDNA与儿童肾移植、重复肾移植、肾小球滤过率、移植肾BK多瘤病毒感染及ddcfDNA检测的影响因素等十个方面进行了论述,并给出了相关专家推荐意见。

  • 13.
    Chinese expert consensus on the clinical management of hematological adverse events associated with chimeric antigen receptor T cell therapy (2022 edition)
    Group of Hematopoietic Stem Cell Transplantation and Cellular Therapy, Hematological Oncology Committee of China Anti-Cancer Association
    Chinese Journal of Transplantation(Electronic Edition) 2022, 16 (01): 13-19. DOI: 10.3877/cma.j.issn.1674-3903.2022.01.002
  • 14.
    Diagnosis and treatment of post-transplant lymphoproliferative disorder confined to renal allograft and literature review
    Xing Wei, Xiang Li, Changqing Chen, Hailong Jin, Ming Cai
    Chinese Journal of Transplantation(Electronic Edition) 2021, 15 (01): 36-41. DOI: 10.3877/cma.j.issn.1674-3903.2021.01.008
  • 15.
    Expert consensus on the care of adult brain-dead potential organ donors
    Chinese Journal of Transplantation(Electronic Edition) 2024, 18 (04): 193-203. DOI: 10.3877/cma.j.issn.1674-3903.2024.04.001
    Abstract (156) HTML (14) PDF (1859 KB) (36)

    At present, China′s transplantation surgery has ranked second in the world.Donation of brain death organs is the main source of organs. However, there is an imbalance in supply and demand development between organ donations and organs transplantation, it is urgent to improve the quality of clinical management of potential donors of brain death, optimize the quality of donation organs, and improve the conversion rate of potential donors. Nursing management plays a very important role in the maintenance of potential organ donors of brain death. This consensus focuses on the nursing points of the system of brain death potential organ donors during the nursing process, and scientifically and regulates recommendati- on opinions, aiming to improve the nursing management system of potential organ donors for adult brain, thereby improving the quality and donation rate of donation organs.

  • 16.
    Repeated gastrointestinal bleeding caused by hereditary hemorrhagic telangiectasia after kidney transplantation: a case report
    Yi Wang, Jiang Qiu, Guodong Chen, Ning Zhang, Qinghua Cao, Yin Li, Lizhong Chen
    Chinese Journal of Transplantation(Electronic Edition) 2021, 15 (03): 175-177. DOI: 10.3877/cma.j.issn.1674-3903.2021.03.011
  • 17.
    Chinese expert consensus on the prevention, diagnosis and treatment of chimeric antigen receptor T cell therapy associated infections (2022 edition)
    Group of Hematopoietic Stem Cell Transplantation and Cellular Therapy, Hematological Oncology Committee of China Anti-Cancer Association
    Chinese Journal of Transplantation(Electronic Edition) 2022, 16 (01): 20-26. DOI: 10.3877/cma.j.issn.1674-3903.2022.01.003
  • 18.
    A case of membrane nephropathy after allogeneic hematopoietic stem cell transplantation treatment with human amniotic epithelial cells
    Huguang Zeng, Ju Sun, Wenbin Liu, Dijiong Wu, Huijin Hu, Qinghong Yu, Yiping Shen, Yuhong Zhou, Baodong Ye
    Chinese Journal of Transplantation(Electronic Edition) 2019, 13 (03): 242-244. DOI: 10.3877/cma.j.issn.1674-3903.2019.03.018
    Abstract (48) HTML (0) PDF (485 KB) (33)
  • 19.
    Chinese clinical guideline for the diagnosis and treatment of sarcopenia in liver transplant recipients
    Transplantation Group, Branch of Organ Transplantation of Chinese Liver, of Organ Transplant Physicians of Chinese Branch
    Chinese Journal of Transplantation(Electronic Edition) 2024, 18 (06): 355-365. DOI: 10.3877/cma.j.issn.1674-3903.2024.06.004
    Abstract (82) HTML (2) PDF (1421 KB) (33)

    Sarcopenia is a group of systemic,progressive skeletal muscle diseases characterized by decreased muscle mass and muscle function due to a variety of etiological factors.The incidence of sarcopenia in liver transplant recipients in China exceeds 40%, which seriously restricts the efficacy of liver transplantation.To standardize and optimize the diagnosis and management of sarcopenia associated with liver transplantation, the Liver Transplantation Group, Branch of Organ Transplantation of Chinese Medical Association; Branch of Organ Transplant Physicians of Chinese Medical Doctor Association have organized experts to summarize and discuss the clinical diagnosis and management of sarcopenia associated with liver transplantation in China by combining the evidence-based medical basis and China&apos;s clinical practice experience, and by drawing on the relevant domestic and international literature.This guideline focuses on the diagnosis, assessment, clinical prevention and treatment of sarcopenia related to liver transplantation, and puts forward a series of recommendations in a scientific and standardized way, aiming at optimizing the perioperative and even mid-and long-term health management of liver transplantation in China.

  • 20.
    High quality development of organ donation in China from a global perspective: 2010-2024
    Wenshi Jiang, Fengzhong Hou
    Chinese Journal of Transplantation(Electronic Edition) 2024, 18 (04): 204-212. DOI: 10.3877/cma.j.issn.1674-3903.2024.04.002
    Abstract (115) HTML (7) PDF (3616 KB) (31)

    Over the past15years,the number of organ donations and &gt;transplants worldwide has shown a tortuous upward trend.In addition to continuously optimizing the prevention strategies for non-communicable diseases related to transplantation, countries are also striving to improve the efficiency of organ donation system, to expand the accessibility to organ transplantation services, and to achieve the sustainable development goals proposed by the United Nations. The present constitute a critical period for our endeavor to move toward national rejuvenation on all fronts through Chinese modernization. Adhering to the principle of &quot;Put People and Their Lives First&quot;, and contributing to promotes Healthy China Initiative and raises socialist cultural-ethical standards, the Chinese organ donation program, with the participation of the Red Cross Society of China as a third party, has gradually embarked on a development path that contains the essence of Chinese modernization,highlighting the development path of complying with laws and regulations, adhering to spiritual guidance, firmly grasping institutional construction, emphasizing humanistic care, following ethical and moral principles, and emphasizing discipline construction. This article firstly reviews the history and current situation of organ donation and transplantation in the past 15 years at home and abroad, and to discusses the required internal and external environmental conditions for the development of organ donation and transplantation based on research data. Secondly, we summarize the characteristics of the current system construction and provide scientific advice for further optimizing the development strategies for organ donation in China.

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